DEMOGRAPHIC INFORMATION

Administered by: Date of Screen:

Name: Date of Birth:

Gender: Date of Arrival: Health ID:

Bilingual versions of the RHS-15 have been translated by an iterative process involving experts in the field, professional translators, and members of the refugee community so that each question is asked correctly according to language and

culture. The English text is provided for reference only; using the English alone negates the sensitivity of this instrument.

Refugee Health Screener-15 (RHS-15)

Amharic Version

Developed by the Pathways to Wellness project and generously funded by Robert Wood Johnson Foundation, Bill and Melinda Gates Foundation, United Way of King County, Medina Foundation, The Seattle Foundation, Boeing Employees Community Fund and M.J. Murdock Charitable

Trust. Production of the Amharic RHS-15 was made possible by the Maryland Department of Health and Mental Hygiene.

© 2013 Pathways to Wellness: Integrating Refugee Health and Well-Being

Pathways to Wellness: Integrating Refugee Health and Well-Being is a project of Lutheran Community Services Northwest, Asian Counseling and Referral Service, Public Health Seattle & King County, and Michael Hollifield, M.D. of Pacific Institute for

Research & Evaluation. For more information, please contact The Pathways Project at 206-816-3253 or pathways@lcsnw.org.

Developed by the Pathways to Wellness project and generously funded by Robert Wood Johnson Foundation, Bill and Melinda Gates Foundation, United Way of King County, Medina Foundation, The Seattle Foundation, Boeing Employees Community Fund and M.J. Murdock Charitable Trust.

Production of the Amharic RHS-15 was made possible by the Maryland Department of Health and Mental Hygiene.

© 2013 Pathways to Wellness: Integrating Refugee Health and Well-Being

Pathways to Wellness: Integrating Refugee Health and Well-Being is a project of Lutheran Community Services Northwest, Asian Counseling and Referral Service, Public Health Seattle & King County, and Michael Hollifield, M.D. of Pacific Institute for Research & Evaluation. For more

information, please contact The Pathways Project at 206-816-3253 or pathways@lcsnw.org.

ስሜቶችSYMPTOMS በፍ

ጹም

N

OT

AT

ALL

ትንሽ

A

LIT

TLE

BIT

በመጠ

ኑ M

OD

ERA

TELY

ከፍተ

ኛ Q

UIT

E A

BIT

ክፉኛ

EXTR

EMEL

Y

1. �የጡንቻ (ጅማት)፣ የአጥንቶች መጋጠሚያ ሕመሞችMuscle, bone, joint pains 0 1 2 3 4

2. �አብዛኛውን ጊዜ የመጫጫን ስሜት፣ የማዘን፣ ወይም ደስተኛ አለመሆን Feeling down, sad, or blue most of the time

0 1 2 3 4

3. ከሚገባ በላይ አብዝቶ ማሰብ ወይም ማውጣት ማውረድ Too much thinking or too many thoughts

0 1 2 3 4

4. መፍትሔ የማጣት ስሜትFeeling helpless

0 1 2 3 4

5. ያለምንም ምክንያት በድንገት መፍራት Suddenly scared for no reason

0 1 2 3 4

6. የመውደቅ ስሜት፣ የማዞር ወይም ድካም ስሜትFaintness, dizziness, or weakness

0 1 2 3 4

7. ከውስጥ የመሸበርና የመርበትበት ስሜትNervousness or shakiness inside

0 1 2 3 4

8. አለመረጋጋት፣ የመቁነጥነጥ ስሜትFeeling restless, can’t sit still

0 1 2 3 4

9. በቀላሉ ማልቀስ፣ ሆደባሻነትCrying easily

0 1 2 3 4

መመሪያዎች፥ በእያንዳንዱ ስሜቶች አጠገብ የሚገኘውን መመዘኛ በመጠቀም፣ እባክዎን ባለፈው ወር ውስጥ የነበረውን የሕመምዎን ደረጃ በተገቢው ዓምድ ውስጥ ምልክት ያድርጉ። ባለፈው ወር ውስጥ ሕመሙ ያመመዎት ካልነበረ፣ “በፍጹም” በሚለው አኳያ ይክበቡ።

INSTRUCTIONS: Using the scale beside each symptom, please indicate the degree to which the symptom has been bothersome to you over the past month. Place a mark in the appropriate column. If the symptom has not been bothersome to you during the past month, circle “NOT AT ALL.”

የስደተኛ ጤና ማጣሪያ (RHS-15)REFUGEE HEALTH SCREENER-15 (RHS-15)

ID#

DATE:

የሚከተሉት ስሜቶች፣ በጦርነት ውይም በስደት ወቅት ካጋጠሙዎት፣ አሰቃቂ ሁኔታዎች ጋር ሊዛመዱ ይችላሉ። ባለፈው ወር ውስጥ የሚከተሉት ስሜቶች ምን ያህል ተከስተው ያውቃሉ፥The following symptoms may be related to traumatic experiences during war and migration. How much in the past month have you:

ስሜቶችSYMPTOMS በፍ

ጹም

N

OT

AT

ALL

ትንሽ

A

LIT

TLE

BIT

በመጠ

ኑ M

OD

ERA

TELY

ከፍተ

ኛ Q

UIT

E A

BIT

ክፉኛ

EXTR

EMEL

Y

10. ያሳለፉት አሰቃቂ ግዜ በአእሙሮዎ እየተመላለሰ አሁንም ያስቸግርዎታል?

Had the experience of reliving the trauma; acting or feeling as if it were happening again?

0 1 2 3 4

11. ያሳለፉትን አሰቃቂ ሁኔታ ሲያስታውሱ በሰውነትዎ ላይ ለምሳሌ የልብ ምት መጨመር ወይም የማላብ ስሜት ይሰማዎታል?

Been having physical reactions (for example, break out in a sweat, heart beats fast) when reminded of the trauma?

0 1 2 3 4

12. �ስሜትዎ የደነዘዘ እንደሆነ ተስምቶት ያውቃል (ለምሳሌ፣ ሃዘን ተሰምቶት ግን ማልቀስ አልቻሉም፣ የማፍቀር ስሜቶች ሊኖርዎት አለመቻል)?

Felt emotionally numb (for example, feel sad but can’t cry, unable to have loving feelings)?

0 1 2 3 4

13. ተደናግጠው፣ በቀላሉ ተጨንቀው ያውቃሉ (ለምሳሌ፣ አንድ ሰው ከኋላዎ እየተራመደ ሲመጣ)?

Been jumpier, more easily startled (for example, when someone walks up behind you)?

0 1 2 3 4

የስደተኛ ጤና ማጣሪያ (RHS-15)REFUGEE HEALTH SCREENER-15 (RHS-15)

ID#

DATE:

Developed by the Pathways to Wellness project and generously funded by Robert Wood Johnson Foundation, Bill and Melinda Gates Foundation, United Way of King County, Medina Foundation, The Seattle Foundation, Boeing Employees Community Fund and M.J. Murdock Charitable Trust.

Production of the Amharic RHS-15 was made possible by the Maryland Department of Health and Mental Hygiene.

© 2013 Pathways to Wellness: Integrating Refugee Health and Well-Being

Pathways to Wellness: Integrating Refugee Health and Well-Being is a project of Lutheran Community Services Northwest, Asian Counseling and Referral Service, Public Health Seattle & King County, and Michael Hollifield, M.D. of Pacific Institute for Research & Evaluation. For more

information, please contact The Pathways Project at 206-816-3253 or pathways@lcsnw.org.

SCREENING IS POSITIVE IF: 1 ITEMS 1–14 IS 12 OR 2 DISTRESS THERMOMETER IS 5

SELF-ADMINISTERED NOT SELF-ADMINISTEREDCHECK ONE: POSITIVE NEGATIVE

SCORING

LEGAL NOTICE 2013 © Pathways to Wellness: Integrating Refugee Health and Wellbeing. Pathways to Wellness is a partnership of Lutheran Community Services Northwest, Asian Counseling and Referral Service, Public Health Seattle and King County and Michael Hollifield, MD of Pacific

Institute for Research and Evaluation. All Rights Reserved.

የሚያጋጥምዎትን ማንኛውንም ነገር ሊቋቋሙት፣ ሊወጡት እንደሚችሉAble to handle (cope with) anything

0

የሚያጋጥሙዎትን አብዛኞቹን ነገሮች ሊቋቋሙት፣ ሊወጡት እንደሚችሉAble to handle (cope with) most things

1

አንዳንድ ነገሮችን መቋቋም፣ መወጣት እንደሚችሉ፣ ግን ሌሎች ነገሮችን፣ ሊቋቋሙ እንደማይችሉAble to handle (cope with) some things, but not able to cope with other things

2

አብዛኞቹን ነገሮች መቋቋም እንደማይችሉUnable to cope with most things

3

ማንኛውንም ነገር መቋቋም እንደማይችሉUnable to cope with anything

4

14. ባጠቃላይ በሕይወትዎ፣ ስለሚከተሉት የሚሰማዎት ምንድን ነው፥ Circle the one best response below. Do you feel that you are:

ክፉኛ ጭንቀት “እንደዚህ አይነት ከፍተ ኛ ጭንቀት

ተጨንቄም አላውቅም”

EXTREME DISTRESS “I feel as bad as I ever have”

ጭንቀት የለም “ሁሉም ነገር ጥሩ ነው”

NO DISTRESS “Things are good”

10

9

8

7

6

5

4

3

2

1

0

እባክዎን የዛሬውንም ጨምሮ ባለፈው ሳምንት ውስጥ የገጠመዎትን የጭንቀት ደረጃ በደንብ የሚገልጸው ቁጥር ላይ (0-10) ይክበቡ።Please circle the number (0 –10) that best describes how much distress you have been experiencing in the past week, including today.

15. የጭንቀት መለኪያ Distress Thermometer

Add Total Score of items 1–14

የስደተኛ ጤና ማጣሪያ (RHS-15)REFUGEE HEALTH SCREENER-15 (RHS-15)

ID#

DATE: